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Medication error trends and effects of person-related, environment-related and communication-related factors on
Elizabeth Manias1,2,3, Noel Cranswick4,5, Fiona Newall3,5,6
1School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Sydney, New South Wales, Australia.
Insights
A 5-year study of Australian paediatric medication errors found that moving to a new hospital site reduced harm. Engaging families also improved error identification, highlighting the importance of hospital design and communication in patient safety.
Area of Science:
- Pediatric patient safety
- Medication error analysis
- Health services research
Background:
- Medication errors in pediatric settings pose significant risks.
- Understanding trends and contributing factors is crucial for improving patient outcomes.
- Hospital infrastructure and communication play a role in medication safety.
Purpose of the Study:
- To analyze medication error trends in a pediatric hospital over five years.
- To assess the impact of person-related, environment-related, and communication-related factors on medication error severity.
- To investigate the influence of hospital site and structure changes on medication error outcomes.
Main Methods:
- Retrospective clinical audit of a 5-year period (July 2010-June 2015).
- Utilized an online voluntary reporting system for medication errors at an Australian tertiary public teaching pediatric hospital.
- Included all reported pediatric medication errors within the specified timeframe.
Main Results:
- A total of 3340 medication errors were reported.
- A new hospital site and structure were associated with significantly reduced odds of medication errors causing harm (P < 0.0001).
- Increased patient and family involvement correlated with higher odds of identifying errors causing harm (P = 0.027).
Conclusions:
- Hospital redesign and improved communication strategies can mitigate medication error harm.
- Encouraging child and family involvement is vital for enhancing medication safety.
- System-level changes, like relocation, can positively impact medication error rates.
Aim:
This study aimed to examine reported medication error trends in an Australian paediatric hospital over a 5-year period and to determine the effects of person-related, environment-related and communication-related factors on the severity of medication outcomes. In particular, the focus was on the influence of changes to a hospital site and structure on the severity of medication errors.
Methods:
A retrospective clinical audit was undertaken over a 5-year period of paediatric medication errors submitted to an online voluntary reporting system of an Australian, tertiary, public teaching paediatric hospital. All medication errors submitted to the online system between 1 July 2010 and 30 June 2015 were included.
Results:
A total of 3340 medication errors was reported, which corresponded to 0.56% medication errors per combined admissions and presentations or 5.73 medication errors per 1000 bed days. The most common patient outcomes related to errors requiring monitoring or an intervention to ensure no harm occurred (n = 1631, 48.8%). A new hospital site and structure had 0.354 reduced odds of producing medication errors causing possible or probable harm (95% confidence interval 0.298-0.421, P < 0.0001). Patient and family involvement had 1.270 increased odds of identifying medication errors associated with possible or probable harm compared with those causing no harm (95% confidence interval 1.028-1.568, P = 0.027). Interrupted time series analyses showed that moving to a new hospital site and structure was associated with a reduction in reported medication errors.
Conclusion:
Encouraging child and family involvement, facilitating hospital redesign and improving communication could help to reduce the harm associated with medication errors.
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